Antipsychotic Stoppage During Pregnancy May Up Relapse Risk

Discontinuation of antipsychotics linked to 60% higher risk of severe psychiatric relapse in women with primary psychotic disorders.

Apr. 14, 2026 at 7:53am

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A highly detailed, translucent X-ray photograph revealing the internal structures of a pregnant woman's abdomen, including the fetus and internal organs, all rendered as glowing, ghostly lines against a dark background, conveying the fragility and complexity of maternal mental health during pregnancy.An X-ray view into the complex maternal-fetal relationship, highlighting the need for careful medication management to protect both mother and child during pregnancy.Mount Sinai Today

A new population-based cohort study found that discontinuation of antipsychotic treatment during pregnancy was associated with a 60% increased risk for severe psychiatric relapse compared to continuation of treatment in women with primary psychotic disorders. While no significant risk was found for women with bipolar disorder, the statistical power for this finding was limited.

Why it matters

This study highlights the importance of carefully managing antipsychotic medication use during pregnancy for women with serious mental health conditions, as abrupt discontinuation can lead to significant health risks for the mother. The findings underscore the need for close collaboration between patients, obstetricians, and psychiatrists to ensure the safest possible outcomes.

The details

The study used data from national birth registers in Denmark and Sweden to identify over 2,000 women with primary psychotic disorders and nearly 1,300 women with bipolar disorder who had at least two antipsychotic prescriptions in the year before pregnancy. Those who discontinued antipsychotics before or during pregnancy were matched 1:1 to those who continued treatment. Discontinuation was defined as no prescription refill within the expected duration plus a 60-day grace period. The primary outcome was severe psychiatric relapse, measured as inpatient treatment during pregnancy and up to 90 days postpartum.

  • The study period spanned pregnancies from 1998 to 2022 in Denmark and 2007 to 2017 in Sweden.

The players

Xiaoqin Liu

PhD, The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

Shelby Smout

PhD, Icahn School of Medicine at Mount Sinai, New York City.

Mollie E. Wood

PhD, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill.

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What they’re saying

“Addressing questions about medication changes before and during pregnancy is complicated by the limitations of existing data sources.”

— Mollie E. Wood, PhD, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill

“Creative strategies, like defining cohorts intending pregnancy or identifying pregnancies that do not end in live births, will often be needed to answer questions about pregnancy from available data and to learn about the effects of decisions about medication use during this period.”

— Mollie E. Wood, PhD, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill

What’s next

The researchers note that further studies with larger sample sizes, particularly for women with bipolar disorder, are needed to confirm these findings and better understand the risks associated with antipsychotic discontinuation during pregnancy.

The takeaway

This study underscores the critical importance of carefully managing antipsychotic medication use for pregnant women with serious mental health conditions. Abrupt discontinuation can significantly increase the risk of severe psychiatric relapse, highlighting the need for close collaboration between patients, obstetricians, and psychiatrists to ensure the safest possible outcomes.